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The private sector, where most Pakistani households seek care, has been largely excluded from nutrition programming. We describe the development and early implementation of Mazboot Bunyad, a digital nutrition registry embedded within an integrated nutrition\u2013immunization programme at private provider clinics in high-risk, low-income settlements of Karachi.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Android application and web dashboard used in this implementation study were designed through a participatory process using the AHEAD framework, in consultation with provincial health authorities, immunization staff, and community nutrition worker. The system used QR-linked child records, an embedded digital decision-support system that classified children by mid-upper arm circumference and has automated follow-up reminders. The tool was deployed across 33 clinics, and routinely collected programme data, a preliminary analysis of data from 1 July to 31 December 2024 were retrospectively reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the period of 6 months, the\n                      <jats:italic>Mazboot Bunyad<\/jats:italic>\n                      application was used to screen and enroll 8,406 children aged 6\u201359 months. Field teams used the embedded Digital Decision Support System (DDSS) to classify children aged 6\u201359 months in real-time. Of these, 71.4% were classified as normal, 22.3% as moderately acutely malnourished (MAM), and 6.2% as severely acutely malnourished (SAM). The largest share of enrollments was among children aged 13\u201324 months (40.5%). Male children represented a slightly larger share of total enrollments (52.2%), but SAM burden was higher among females (7.3%) compared to males (5.3%). Supervisory teams used the dashboard to identify defaulters, monitor stock availability, and follow case recovery timelines.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Early implementation of\n                      <jats:italic>Mazboot Bunyad<\/jats:italic>\n                      highlighted opportunities for enhanced nutritional surveillance using real-time tracking, but also challenges such as supply chain gaps that could affect the overall implementation. These offer valuable lessons for scaling digital tools in real world settings across Pakistan and other LMICs.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s44247-026-00303-7","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:49:11Z","timestamp":1791197351000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and implementation of \u201cMazboot Bunyad\u201d: a digital health intervention for the screening and management of undernutrition among children aged 6\u201359 months, at private provider clinics in urban slums of Karachi, Pakistan"],"prefix":"10.1186","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4531-8472","authenticated-orcid":false,"given":"Shifa Salman","family":"Habib","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammarah","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4416-4379","authenticated-orcid":false,"given":"Muhammad Fazal Hussain","family":"Qureshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shehla","family":"Zaidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fasih","family":"Hansmukh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wardah","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahira","family":"Hasham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajad","family":"Alam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Memon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveed","family":"Bhutto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7532-366X","authenticated-orcid":false,"given":"Diwakar","family":"Mohan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahid Ali","family":"Memon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"303_CR1","doi-asserted-by":"publisher","unstructured":"Asim M, Nawaz Y. 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No personally identifiable information was used in the analysis. Data access was restricted to authorized personnel and stored securely in password-protected systems compliant with local data protection protocols.","order":1,"name":"Ethics","label":"<b>Ethical approval<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all parents or caregivers prior to child enrollment in the digital nutrition registry.","order":2,"name":"Ethics","label":"<b>Consent to participate<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"<b>Consent for publication<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"72"}}